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SAM II Exam 1 > Intro to GI, Vomiting, Stomach > Flashcards

Intro to GI, Vomiting, Stomach Flashcards

random things to remember

1
Q

Which of the following is the best way to evaluate how a bolus forms and is the next step to perform after radiographs when determining the cause of dysphagia?
A) Upper GI endoscopy
B) MRI for brain stem lesion
C) Fluoroscopy
D) Antibodies for Ach-esterase receptor or MMM

A

C

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2
Q 
All emetic stimuli ultimately converge in the \_\_\_\_.
A) Emetic center
B) CRTZ
C) Vestibular apparatus
D) All of the above
A

A!
B= mediates vomiting associated w/ drugs, toxemias, and metabolic dzs; stimuli travel to the emetic center either directly or indirectly via CRTZ

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3
Q

What is the preferred flotation material when looking for giardia and nematodes on a fecal?

A

Zn suflate

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4
Q

Which of the following is false regarding cobalamin?
A) Water soluble vitamin
B) Absorption only occurs in the ileum in dogs and cats
C) Will be reduced if IF is reduced, bacteria are competing for it, or in mucosal dz
D) Dietary deficiency is common

A

D- not common, reduced levels indicated reduced availability in the ileum

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5
Q

T/F: High folate levels correlate with low bacterial levels.

A

False- bacterial overgrowth

also correlate with EPI, jejunal dz, and some Irish setters and GSH w/ gluten enteropathy

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6
Q 
Which of the following combinations is more suggestive of bacterial overgrowth?
A) High cobalamin, high folate
B) Low cobalamin, low folate
C) High folate, low cobalamin
D) Low folate, high cobalamin
A

C@

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7
Q 
What is the test of choice for diagnosing EPI in dogs?
A) TLI 
B) Pancreatic lipase 
C) Amylase 
D) CPLI
A

A (TLI= trypsin like immunoreactivity= TOC)>
evaluate in combo w/ cobalamin/folate levels

CPLI= canine pancreatic lipase immunoreactivity=decreased in dogs w/ EPI, increased in dogs with pancreatitis but also if they have renal dysfunction

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8
Q

Group of idiopathic chronic GI disorders characterized by infiltration of the GIT w/ inflammatory cells

A

Inflammatory bowel dz- IBD
most common histologic dx in dog and cat w/ chronic V/D
-D/t abnormal immune response to> diet,bacteria, or gut itself

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9
Q

T/F: In the dog the pancreatic duct fuses with the bile duct before opening on the major duodenal papilla= one opening into duodenum.

A

false- this is cats, dogs have two openings

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10
Q

Which of the following is true regarding ultrasound diagnosis of pancreatitis?
A) Will see an increase in echodensity= more hyperechoic
B) Not a very helpful tool
C) Radiology is more effective
D) Will see loss of echodensity= more hypoechoic

A

D

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11
Q 
Where are the dopamine receptors that trigger vomiting located?
A) Higher brain centers
B) CRTZ
C) Emetic center
D) All of the above
A

B

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12
Q 
Which emetic receptors are located in the CRTZ, emetic center, and abdomen?
A) NK1
B) D2
C) GAVA
D) 5-HT3
A

A!
Cerenia is great because it acts on these receptors so it prevents vomiting that is triggered indirectly via the CRTZ or directly via the emetic center

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13
Q 
Which of the following drugs are emetogens that act on the CRTZ?
A) Metoclopramide
B) Chlorpromazine
C) Apormorphine
D) Cerenia
E) Cisplatin
A

CE

the rest are antiemetics on this region

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14
Q 
You want a drug to target the emetic receptors of the abdomen, which drug will you choose?
A) Metoclopramide
B) Ondasetron
C) Omeprazole
D) Chlorpromazine
A

B!

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15
Q

Chyme is the food in the area of the ___, characterized as a semi-solid, soapy mixture.

A

duodenum

food bolus is termed chyme after it has interacted with gastric HCl, salts, enzymes, water, and mucus

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16
Q

T/F: The auerbach’s (myenteric) plexus is located in the submucosal layer of the stomach.

A

false- the muscularis layer has these
submucosa contains which plexus?

meissner’s plexus^
also dense CT, blood vessels, and lymphatics

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17
Q

What layer is the connective tissue layer of the stomach?

A

serosa

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18
Q

Which of the following is false regarding digestion in the stomach?
A) Absorption of glucose and alcohol occurs here
B) HCl activates enzymes and kills bacteria
C) Rennin converts protein into polypeptides
D) All are true

A

C- this is pepsin; rennin converts protein into insoluble curds for hydrolysis by pepsin

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19
Q

Which is false regarding gastrin?
A) stimulates secretion of gastric acid and intrinsic factor from parietal cells
B) stimulates secretion of pepsinogen from chief cells
C) Stimulates insulin release
D) Promotes intestinal motility

A

C! which hormone does this? GIP (gastric inhibitory polypeptide)- GIP also reduces gastric acid secretion and intestinal motility

produced in the gastric antrum, duodenum (G cells), and pancreas

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20
Q

Which of the following is false regarding CCK?
A) Contracts sphincter of Oddi
B) stimulates gallbladder contraction
C) Stimulates release of pancreatic enzymes
D) Plays a role in reducing satiety

A

A- relaxes it so that bile and enzymes are released from gall bladder

produced in the duodenum and jejunum (I cells)

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21
Q

T/F: Secretin is produced in the duodenum and jejunum (S cells) and stimulates secretion of HCO3- from the stomach.

A

false- from the pancreas

it also inhibits gastrin and gastric acid secretion

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22
Q

VIP is localized in the enteric nerves and plays what role?
A) Increases water and electrolyte secretion from the pancreas and guy
B) stimulates gallbladder contraction
C) Stimulates release of pancreatic enzymes
D) Plays a role in reducing satiety

A

A

also relaxes smooth muscles of the gut via NO

23
Q

What hormone increases small bowel motility and gastric emptying?

A

Motilin

during fasting the Migrating Motor Complex controls the motility

24
Q

T/F: Somatostatin increases secretion and action of the GIT hormones.

A

False- inhibits the secretion/action

25
Q

Can you list the components of the stomach mucosa?

A
  • superficial epithelium> lamina propria below
  • Gastric glands
  • neuroendocrine cells- somatostatin and gastrin act here
  • muscularis mucosa= thin
26
Q

T/F: Most of the intrinsic factor in dogs comes from the stomach, this is important for B12 (cobalamin) absorption in the GIT.

A

false- most comes from the pancreas, little comes from parietal cells in the stomach

27
Q

T/F: Pepsin in the stomach acts to digest proteins while gastric lipase acts to digest fat.

A

true

28
Q

T/F: Surgery is always indicated in cases of food bloat.

A

false- can withhold food, give fluids, walk frequently and manage pain…if severe surgery is indicated

29
Q 
Which of the following is not expected in cases of gastric erosion/ulcers?
A) Hematemesis
B) Retching 
C) Hematochezia
D) Melena
A

C this occurs in distal GIT, will see melena here

30
Q

T/F: If there is a lot of gas obscuring the image of the stomach on the x-ray, U/S is a better tool to use.

A

false- U/S doesn’t like gas

31
Q

Best method for confirming and biopsy of gastric ulceration?

A

endoscopy

32
Q

T/F: Helicobacter can be present normally in the stomach but is more likely to be pathologic if infiltrated into gastric crypts.

A

true> could be the cause of the ulcer

33
Q

Which of the following is false regarding treatment of helicobacter gastritis?
A) Triple therapy is normally used, meaning an abx, antacid, and peptobismol
B) Treatment is not indicated as Helicobacter has not been linked to gastric ulcers
C) Common abx include metronidazole (flagyl), tetracycline, and amoxicillin
D) Omeprazole and Pepcid are antacids used

A

B

34
Q

Before you attempt to diagnose parasites in the GIT with endoscopy they should be dewormed at least __ times.

A

3 times

35
Q

Fenbendazole and pyrantel can be used to treat roundworms in cats and dogs. Which parasite is only in cats and is treated with fenbendazole?
A) Physalloptera
B) Ollulanus tricuspsi
C) A/B

A

B!
A is in cats and dogs, treated with pyrantel

A= difficult to see on float
B= see on biopsy, gastric juice eval or in vomitus
36
Q

Which is false regarding pythiosis?
A) Is very aggressive and associated with standing water
B) Results in chronic vomiting and has a high fatality rate
C) There is a vaccine available
D) Treated with antimicrobials
E) Involves a pyogranulomatous inflammation

A

D- antifungals> terbinafine and itraconazole

37
Q 
GERD involves reflux of contents from the:
A) Stomach
B) Duodenum
C) Jejunum
D) A/b
E)  B/C
A

D- can have duodenal contents refluxing into the stomach and then esophagus&raquo_space; GERD is secondary to something! signs= lip licking, hard swallow, ptyalism, and esophagitis

38
Q 
What is the #1 inflammatory component with inflammatory gastritis?
A) Mast cell
B) Lymphoplasmocytic
C) Eosinophilic
D) Neutrophilic
A

B

diagnosed via biopsy- see inflammatory cells in the mucosa and lamina propria of stomach

39
Q 
Which of the following is not indicated prior to biopsy of the stomach for suspected inflammatory gastritis?
A) Antacids/gastroprotectants
B) Antiemetics
C) Empiric deworming
D) Corticosteroids
E) Diet trial
A

D

don’t use any immunotherapy before biopsy- includes cyclosporine/atopica, mycophenolate, azathoprine, chlorambucil

40
Q 
Which drug is often used if a dog is experiencing too many side effects from prednisone?
A)cyclosporine/atopica
B) mycophenolate
C) azathoprine
D) chlorambucil
A

B

41
Q 
This drug has been linked to causing pancreatitis and bone marrow suppression.
A)cyclosporine/atopica
B) mycophenolate
C) azathoprine
D) All of the above
A

C

42
Q 
Used with inflammatory gastritis in cats, is a chemo drug.
A)cyclosporine/atopica
B) mycophenolate
C) azathoprine
D) chlorambucil
A

D

43
Q

What is the sequela to inproper treatment of inflammatory gastritis or treatment failure of gastritis?

A

atrophic gastritis= chronic vomiting, marked mononuclear infiltrate, thinning of gastric mucosa, atrophy of gastric glands > decreased ruggal folds= decreases ability to digest

44
Q 
What condition is associated with gastrin secreting tumors, causes projectile chronic vomiting hours after eating, and is seen in older small dog breeds such as the lhasa apso and shih tzu?
A) Inflammatory gastritis
B) Hypertrophic gastropathy
C) GERD
D) None of the above
A

B= associated with hypergastrinemic conditions> see a pronounced pyloric outflow region commonly

not directly treatable, must treat underlying condition; may be able to surgically remove thickened tissue

45
Q

What are the breeds of dogs (3) and the one breed of cat that more commonly get congenital pyloric stenosis/hypertrophy?

A
  • boxers, Bostons, english bulldog

- siamese cats

46
Q

T/F: Classic signs of pyloric hypertrophy include vomiting right after a meal.

A

false! this condition results in delayed gastric emptying and thus vomiting several hours after a meal> can aspirate and develop pneumonia, other signs include poor weight gain, depression, and dehydration

tx w/ surgery

acquired forms result from either inflammation or neoplasia= gastrinoma

47
Q

What is zollinger-ellison syndrome?

A

Syndrome associated with gastrinomas= gastrin secreting tumor> most notable CS= chronic vomiting, also develop reflux esophagitis

48
Q

T/F: Gastrinomas cause gastric hypertrophy and ulceration but the tumor is located in the liver.

A

False- first part true, but the tumor is in the pancreas usually

49
Q

T/F: Gastrin levels can be sent to TAMU to determine if there is a gastric secreting tumor present. A fasting serum should be collected and shipped on ice packs ASAP as gastrin is not stable at room temp.

A

false- most of it is right but the sample must be immediately FROZEN and shipped on dry ice, even on ice packs gastrin will only be stable for 4 hrs

50
Q

T/F: Gastrinomas do not often metastasize.

A

False- often is already metastasized at time of dx» gaurded to poor prognosis

51
Q 
Which of the following is a way that gastrinomas can be treated?
A) High doses of proton pump inhibitors
B) Octreotide
C) Surgical removal
D) A/C
E) All of the above
A

E

B is a drug that inhibits gastrin, not commonly used but can be

52
Q 
Which of the following is the most common neoplasia of the canine stomach?
A) Gastrinoma
B) Adenocarcinoma
C) Lymphosarcoma
D) Leiomysarcoma
A

B!
A= in pancreas, just causes gastric changes
C= Cats!!!

53
Q

Which is false of bilious vomiting syndrome?
A) More common in older dogs
B) Is the early morning vomiting of bile
C) Can be treated w/ small frequent meals, prokinetics such as metoclopramide, and gastroprotectants
D) All are true

A

A= young dogs

SAM II Exam 1 (5 decks)

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